- Cognizant (Madison, WI)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Madison, WI)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- Humana (Madison, WI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action… more
- Humana (Madison, WI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Humana (Madison, WI)
- …make an impact** **Required Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary ... health first** This is an opportunity to use your clinical knowledge and research skills to support the coordination,...an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication,… more
- Fresenius Medical Center (Fitchburg, WI)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- Humana (Madison, WI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Molina Healthcare (Madison, WI)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support...hearings as may be required. * Serves as a clinical resource for utilization management, chief medical… more
- CenterWell (Madison, WI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
- Humana (Madison, WI)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... Facilities to obtain sufficient clinical information. The Utilization Management Behavioral Health Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Molina Healthcare (Madison, WI)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse (RN). License must be active and unrestricted in ... for denial or modification of payment decisions. + Serves as a clinical resource for utilization management, CMOs, physicians and member/provider… more
- Humana (Madison, WI)
- …**Use your skills to make an impact** **Required Qualifications** + **Active Registered Nurse (RN) Multi-state/Compact State license with no disciplinary ... medication adherence and is trained to act as a clinical concierge. The NAL Telephonic Nurse role...care, skilled or rehabilitation setting, home health, DME, triage, utilization , or case management. + **Ability to work ANY… more
- Sharecare (Madison, WI)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Veterans Affairs, Veterans Health Administration (Madison, WI)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... process and initiatives as well as customer service programs. The RN Nursing Clinical Analyst is responsible for providing local or regional-level analysis of data… more
- Meriter-UnityPoint Health (Madison, WI)
- …driver's license when driving any vehicle for work-related reasons. + Currently licensed as Registered Nurse and able to practice in the State of Wisconsin. + ... Psychiatry OP Location:Child/Adolescent Psych Hospital Job Description: The Child and Adolescent Clinical Resource Nurse and Outpatient Case Manager serves four… more
- Molina Healthcare (Madison, WI)
- …behavioral health, or equivalent combination of relevant education and experience. + Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed ... **Required Qualifications** + At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of… more
- Molina Healthcare (Poynette, WI)
- …experience. * At least 1 year of health care management/leadership experience. * Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical ... Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist...Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse (RN). License must be active… more
- SSM Health (Madison, WI)
- …Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse (RN) Issued by Compact State + Or + Registered ... in standard work. + May also be responsible for: utilization management process, ED case management process, admission process,...of Professional Registration State of Work Location: Oklahoma + Registered Nurse (RN) Issued by Compact State… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- Summary The Community Care (CC) Referral Coordination Team (RCT) Registered Nurse (RN) is responsible for executing a streamlined approach to receiving, ... possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, ...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (Madison, WI)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. The Informaticist RN-Bar Code Medication Administration (BCMA)… more